14th Congress of the Polish Transplantation Society–Part IILiver transplantationHigher Concentrations of Cyclosporine Metabolites in Liver Transplant Recipients With a History of Viral and Bacterial Infections
Section snippets
Material and Methods
Blood samples were obtained from LTX recipients who gave their written informed consent to participate in this study. Forty-three stable patients following LTX were included in the study. The median age was 50.4 years, interquartile range (IQR) 31.8 to 59.1. The group included 22 male (51.2%) and 21 female (48.8%) subjects. The median post-transplant time was 107.4 months, IQR 48.7 to 162.1. 2 mL trough blood samples were collected into ethylenediamine tetraacetic acid–containing tubes during
Results
Patients’ characteristics and concentrations of CsA and its metabolites are presented in Table 1. Liver recipients with a history of EBV infections had higher DiHCsA, TriHCsA, DemCarbCsA, AM1/CsA, DiHCsA/CsA, and TriHCsA/CsA i DemCarbCsA/CsA in comparison with subgroup without such infection (498.396 ± 591.829 vs 53.042 ± 44.923, P = .049; 33.368 ± 41.548 vs 1.627 ± 2.558, P = .037; 28.222 ± 34.506 vs 0.482 ± 1.007, P = .006; 639.605 ± 41.797 vs 384.162 ± 120.946, P = .018, 654.547 ± 716.736 vs
Discussion
Infections are often the cause of morbidity and mortality in LTX recipients. Among 2761 solid organ transplant recipients (including 577 LTX recipients), 1520 patients (55%) suffered 3520 infections during the first year post-transplantation [5]. Authors underline that, in the whole group, the most common complication was bacterial infection (63%). However, in LTX patients, EBV infection also seems to be a serious problem. It can lead to post-transplant lymphoproliferative disorder (PTLD),
Conclusions
In conclusion, in LTX recipients with a history of viral or bacterial infections, higher concentrations of CsA metabolites were observed. It is possible that the quantification of CsA metabolites could be a part of therapeutic drug monitoring strategy and could be used to assess the risk of infection in patients after LTX. This hypothesis should be confirmed in further investigations.
References (18)
- et al.
Two rapid ultra performance liquid chromatography/tandem mass spectrometry (UPLC/MS/MS) methods with common sample pretreatment for therapeutic drug monitoring of immunosuppressants compared to immunoassay
J Chromatogr B Biomed Appl
(2013) - et al.
Hydroxylated, hydroxymethylated, dihydroxylated, and trihydroxylated cyclosporine metabolites can be nephrotoxic in kidney transplant recipients
Transplant Proc
(2016) - et al.
Impact of EBV infection and immune function assay for lymphoproliferative disorder in pediatric patients after liver transplantation: a single center experience
Hepatobiliary Pancreat Dis Int
(2020) - et al.
Cyclosporine metabolism in transplant patients
Pharmac Ther
(1993) - et al.
Cytochrome P-450 hPCN3, a novel cytochrome P-450 IIIA gene product that is differentially expressed in adult human liver. cDNA and deduced amino acid sequence and distinct specificities of cDNA expressed hPCN1 and hPCN3 for the metabolism of steroid hormones and cyclosporine
J Biol Chem
(1989) - et al.
High-performance liquid chromatographic method for therapeutic drug monitoring of cyclosporine A and its two metabolites in renal transplant patients
J Chromatogr B
(2000) - et al.
Cardiovascular disease in kidney transplantation and its association with blood concentrations of cyclosporine and cyclosporine metabolites
Transplant Proc
(2018) - et al.
Determination of cyclosporine and its metabolites in blood via HPLC-MS and correlation to clinically important parameters
Transplant Proc
(2005) CNIs: immediate benefits but storing problems for the future?
Transplantation
(2008)
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This work was supported by Polish National Science Centre, Poland (grant no. 2013/09/B/NZ2/00275) and Polish National Centre of Research and Development, Poland (grant no. NR13014410).